FREQUENCY OF ACUTE KIDNEY INJURY (AKI) AMONG NEWBORNS HAVING BIRTH ASPHYXIA PRESENTING AT TERTIARY CARE/ GMC TEACHING HOSPITAL SUKKUR

Abstract

Background: Asphyxia at birth is a leading cause of neonatal morbidity and mortality globally, and is often complicated by multiorgan dysfunction. The kidneys are especially susceptible to hypoxic-ischemic injury and develop acute kidney injury (AKI). Early diagnosis of AKI is critical because it can play a large role in the morbidity and mortality for the neonate.

Objective:  To determine the frequency of acute kidney injury (AKI) among newborns having birth asphyxia presenting at tertiary care/ GMC teaching hospital Sukkur.

Methodology: This was a cross-sectional descriptive study that was carried out at Department of Pediatric Medicine, Ghulam Muhammad Mahar Medical College (GMC) Teaching Hospital Sukkur from January 2025 to May 2025. The neonates of the term were sampled consecutively and 116 neonates with birth asphyxia were enrolled. A structured proforma was used to record the demographic and clinical characteristics. The diagnosis of acute kidney injury was made if there was a serum creatinine level >1.5 mg/dL and urine output of <1 mL/kg/hour. The data were analyzed using the SPSS 26.0 Software. Frequency, percent, mean and standard deviation were computed. For possible effect modifiers, stratification was carried out.

Results: The mean age in 116 neonates with birth asphyxia was 3.2±1.4 days and 67 (57.8%) were male. A total of 27 (23.3%) neonates had acute kidney injury. Grade-I AKI was observed in 14 (51.9%), Grade-II in 8 (29.6%), and Grade-III in 5 (18.5%) affected neonates. Neonatal seizures and severe birth asphyxia were significant relations with AKI (p<0.05). Conclusion: Acute kidney injury is a common complication in newborn with birth asphyxia. Early diagnosis and prompt intervention might lessen renal complications and better the neonatal outcome.